Pediatr Diabetes. 2020 Mar;21(2):215-223. doi: 10.1111/pedi.12949. Epub 2019 Dec 10.

Prevalence of responders for hepatic fat, adiposity and liver enzyme levels in response to a lifestyle intervention in children with overweight/obesity: EFIGRO randomized controlled trial.

Pediatric diabetes

María Medrano, Lide Arenaza, Robinson Ramírez-Vélez, Francisco B Ortega, Jonatan R Ruiz, Idoia Labayen

PMID: 31778277 DOI: 10.1111/pedi.12949

Abstract

BACKGROUND/OBJECTIVE: Exercise and lifestyle interventions have been shown to reduce hepatic fat (HF) and adiposity in youth. However, the interindividual response in HF after a lifestyle intervention with or without exercise in children is unknown. The aim of the present study was to compare interindividual variability for HF, adiposity, gamma-glutamyl transferase (GGT), and the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) in children with overweight/obesity participating in a 22-week lifestyle intervention with (intensive intervention) or without exercise (control intervention).

METHODS: Data from 102 children (9-12 years, 55% girls) with overweight/obesity participating in the EFIGRO randomized controlled trial were analyzed. Percentage HF (magnetic resonance imaging), weight, body and fat mass index (BMI and FMI), GGT, AST/ALT, cardiorespiratory fitness (CRF, 20 meters shuttle run test) were assessed before and after the intervention by the same trained researchers. The control intervention consisted in 11 sessions of a family-based lifestyle and psycho-educational program. The intensive intervention included the control intervention plus supervised exercise (3 sessions/week).

RESULTS: The prevalence of responders for HF (54% vs. 34%), weight (27% vs. 11%), BMI (71% vs. 47%), FMI (90% vs. 60%), and GGT (69% vs. 39%) was higher in the intensive than in the control group (Ps < 0.05). Responders for weight (16 ± 3 vs. 6 ± 2 laps) and BMI (11 ± 2 vs. 3 ± 4 laps) improved more CRF levels than non-responders (Ps < 0.05).

CONCLUSIONS: The addition of exercise to a lifestyle intervention may increase the responder rates for HF, adiposity, and GGT in children with overweight/obesity. Improvements in CRF may explain differences between weight and BMI responders and non-responders.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02258126.

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Keywords: cardiorespiratory fitness; exercise intervention; interindividual variability; nonalcoholic fatty liver disease; pediatric obesity

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MeSH terms

• Adiposity
• Child
• Exercise*
• Female
• Healthy Lifestyle*
• Humans
• Liver / enzymology
• Male
• Non-alcoholic Fatty Liver Disease / therapy*
• Pediatric Obesity / therapy*
• Risk Reduction Behavior
• Weight Reduction Programs

Publication Types

• Comparative Study
• Journal Article
• Research Support, Non-U.S. Gov't